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Dear Colleague Letters										Related Pages
										For the latest information, please visit Uniting for Ukraine: Information for TB ProgramsReturn to Main Menu
**Uniting for Ukraine Program**
June 21, 2022
Dear Colleagues,
The Uniting for Ukraine ProgramThis letter provides an overview of the tuberculosis screening requirements for Ukrainian parolees entering the United States through the Department of Homeland Security (DHS) Uniting for Ukraine Program (the Program),Uniting for Ukraine | Homeland Security (dhs.gov). The Program is a pathway for Ukrainian citizens and their immediate family members who are outside the United States to come to the United States and stay temporarily in a two-year period of parole. Ukrainians participating in the Program must meet specific requirements, including a health attestation for tuberculosis screening.
Vaccination and Tuberculosis Requirements under the ProgramThe Ukrainian parolees must meet health requirements under DHS rules that were developed in consultation with the Centers for Disease Control and Prevention (CDC). The applicants for parole are instructed to seek medical care and to record the completion of health requirements for vaccinations and tuberculosis testing by submitting a Uniting for Ukraine Vaccine Attestation Form,Uniting for Ukraine Vaccine Attestation | USCIS. The requirement for tuberculosis testing with an interferon-gamma release assay (IGRA) must be met within 2 weeks of entry.
Ukrainian parolees may be referred to health departments for an IGRA test. If the health department cannot provide this test, please refer them to other resources. A tuberculin skin test will not be accepted in place of an IGRA. DHS is collecting attestations online but is not requesting IGRA reports or other health records; the applicants are instructed to retain these records. CDC’s Electronic Disease Notification System,EDN, does not have information about the Ukrainian parolees because they have not undergone the overseas immigration medical examination. The health requirements under the Program are not the same as the Civil Surgeons Medical History and Physical Examination for the adjustment of status,Civil Surgeons Instructions.
Funding for Tuberculosis Testing and Other Health ServicesCDC will be receiving funding for addressing some of the costs stemming from the Program, and part of those funds are specifically for tuberculosis needs including laboratory services. CDC’s Division of Tuberculosis Elimination (DTBE) and the Office of Grant Services (OGS) are determining the fastest, most flexible funding mechanisms for helping to meet the needs at state and big city health departments. We will send you further information and instructions when the mechanisms have been made final.
Ukrainian parolees may be eligible for federally funded health coverage programs such as Medicaid and Refugee Medical Assistance (RMA),Benefits for Ukrainian Humanitarian Parolees. The Office of Refugee Resettlement (ORR) in the Administration for Children and Families funds State Refugee Health Coordinators to oversee the domestic medical screening recommended by CDC,Domestic Medical Examination. This screening program varies in services, funding, and structure across states; however, tuberculosis testing may be a component of the domestic medical screenings. Valid documentation of IGRA tuberculosis testing completed to meet the DHS 2-week attestation requirement can be used for the domestic medical screening and prevent unnecessary retesting. We encourage you to reach out to the State Refugee Health Coordinator in your state,ORR Key State Contacts, to collaborate on tuberculosis screening services.
CDC is not collecting data from the attestations or the IGRA results. We encourage you to collect information about tuberculosis testing and screening, consistent with your routine systems for refugee health, surveillance, and program management.
Ukrainians who Entered the United States Before the Uniting for Ukraine ProgramUkrainians who were paroled into the United States before the Program or who were in the United States already under various visas presently do not have to meet health requirements such as TB testing. However, some may be eligible for federally funded health benefits and services.
Tuberculosis in UkraineUkraine has a high incidence of tuberculosis compared to the United States, and multidrug resistance has been highlighted by the World Health Organization,WHO information note. The European Centre for Disease Prevention and Control has alerted its member nations about infectious diseases including tuberculosis in Ukraine,ecdc TECHNICAL REPORT.
Information About Tuberculosis for UkrainiansPatient educational materials that have been translated into Ukrainian can be found on a CDC website,Uniting for Ukraine: Information for TB Programs. The materials are free and can be downloaded.
Further InformationCDC will share additional information based on future developments. Please check frequently with your refugee health colleagues for their updates. Contact your CDC DTBE Tuberculosis Cooperative Agreement Project Officer with questions.

Sincerely,
Terence Chorba, MD, DSc, LLM, MPH, MPA, FACP, FIDSAChief, Field Services Branch, Division of Tuberculosis EliminationNational Center for HIV, Viral Hepatitis, STD, and TB Prevention
							
					
						Page last reviewed:  June 28, 2022					Content source: 	Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention homeTuberculosisBasic TB Factsplus iconHow TB SpreadsLatent TB Infection and TB DiseaseSigns & SymptomsTB Risk FactorsExposure to TBTB PreventionVaccinesTB & HIV CoinfectionTB and DiabetesTB TermsPersonal StoriesTesting & Diagnosisplus iconWho Should be TestedTesting for TB InfectionTesting in BCG-Vaccinated PersonsTB Screening and Testing of Health Care PersonnelTesting During PregnancyDiagnosing latent TB infection and TB diseaseTreatmentplus iconDeciding When to Treat Latent TB InfectionTreatment Regimens for Latent TB Infection (LTBI)Treatment for TB DiseaseAdverse EventsTB Treatment of Persons Living with HIVTB Treatment and PregnancyTB Treatment for ChildrenFrequently Asked QuestionsDrug-Resistant TBResearchplus iconTB Epidemiologic Studies Consortiumplus iconResearch ProjectsPublicationsTB Trials Consortiumplus iconStudy DescriptionsBackgroundBehavioral & Social Science ResearchHealth Care Settingsplus iconTB Infection Control in Health Care SettingsResources for TB Screening and Testing of Health Care Personnelplus iconFrequently Asked QuestionsTB in Specific Populationsplus iconHealth DisparitiesAsian PersonsBlack or African American PersonsHispanic or Latino PersonsChildrenPregnancyCorrectional FacilitiesPeople Experiencing HomelessnessInternational TravelersLaboratory Informationplus iconDrug Susceptibility TestingFalse-Positive Investigation ToolkitInterim Laboratory Biosafety Guidance for XDR  tuberculosis strainsModel Performance Evaluation Program (MPEP)Rapid Molecular Testing to Detect Drug-Resistant TB in the USplus iconExecutive SummaryIntroductionBackground on Tests for Molecular Detection of DRGeneral Considerations and Principles for a Molecular DR Testing ServicePossible Scenarios and Scope of Testing for a Molecular DR Testing ServiceResearch NeedsGeneral Recommendations of the Expert PanelCommunication Plan for the ReportRecommendationsReferencesPanel Members and CDC ParticipantsAppendix 1Appendix 2Appendix 3The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TBplus iconGeneral ConsiderationsGeneral Recommendations of the Expert PanelRecommendations to ACET, CDC, DTBEData & Statisticsplus iconTB Incidence in the United StatesReported TB in the US, 2022 Surveillance Reportplus iconNational DataReporting Area DataRisk FactorsDemographicsTB Treatment and Case OutcomesDrug-Resistant TBMolecular SurveillanceTuberculosis in the United States, 2022 (Slide Set)Archived Surveillance Reports and Slide Sets2021 State and City ReportArchived State and City ReportsProfessional Resources & Toolsplus iconTools for Healthcare ProvidersResources for TB Programsplus iconStrengthening Civil Surgeons’ Capacity to Improve LTBI Surveillance and Outcomes Among Status AdjustersNotice of Funding Opportunity (NOFO)Program EvaluationTB Centers of ExcellenceTB Elimination AllianceTB Genotypingplus iconConventional TB GenotypingWhole Genome SequencingTB GIMSAnalytic ToolsLatent Tuberculosis Infection ResourcesPublications & Productsplus iconPatient and Public MaterialsFact SheetsGuidelinesplus iconControl & EliminationDrug-Resistant TBInfection Control & PreventionLaboratory & GenotypingTB & HIVTB in Specific PopulationsTesting & DiagnosisTreatmentVaccines & ImmunizationsArchived TB GuidelinesGuides & Toolkitsplus iconAggregate ReportsCDC TB Surveillance TrainingCore CurriculumEffective TB Interviewing for Contact InvestigationEthnographic GuidesFalse-Positive Investigation ToolkitForging Partnerships to Eliminate TuberculosisGuide to Application of GenotypingLTBI: A Guide for Primary Health Care ProvidersMantoux Tuberculin Skin Testing ProductsReport of Verified Case of Tuberculosis (RVCT)Self-Study ModulesTB Contact Investigation Interviewing Skills CourseTB eDOT ToolkitUnderstanding the TB Cohort Review ProcessNewslettersplus iconTB Notes, No. 4, 2023TB Notes, No. 3, 2023TB Notes. No. 2, 2023TB Notes. No. 1, 2023TB Notes, No. 4, 2022TB Notes, No. 3, 2022TB Notes, No. 2, 2022TB Notes, No. 1, 2022TB Notes, No. 4, 2021TB Notes, No. 3, 2021TB Notes, No. 2, 2021TB Notes, No. 1, 2021Pamphlets, Brochures, Bookletsplus iconQuestions and AnswersPatient Education SeriesTuberculosis - Get the FactsTuberculosis - The Connection between TB and HIV12-Dose Regimen for Latent TB Infection-Patient Education BrochurePostersplus iconMantoux Tuberculin Skin Test Wall ChartWorld TB DayThink TBStop TBTake on TBReports & Articlesplus iconDTBE Authored Journal ArticlesTuberculosis Laboratory Aggregate ReportsSlide Setsplus iconIntroduction to TuberculosisEpidemiology of Tuberculosis Among Non-U.S.​–Born Persons in the United States, 1993–2016Self-Study Modules on Tuberculosis, 1-5 Slide SetsThe Tuberculosis (TB) in Correctional Settingsplus iconFacilitator GuideIntroduction to TB GenotypingEpidemiology of Tuberculosis in Correctional Facilities, United States, 1993-2017Prevention and Control of Tuberculosis in Correctional and Detention FacilitiesGuidelines for Preventing the Transmission of M. TB in Health care SettingsInvestigation of Contacts of Persons with Infectious TBEpidemiology of Pediatric Tuberculosis in the United StatesTargeted Tuberculosis Testing and Treatment of Latent Tuberculosis InfectionElectronic Tools & ResourcesWeb-Based Courses & Webinarsplus iconTB 101 for Health Care WorkersContent SyndicationInfographicsplus iconSocial Media GraphicsCustomizable Take on TB Infographic with InstructionsEventsWorld TB Dayplus iconU.S. TB ChampionsHistoryFeaturesplus iconTB Risk FactorsTreating Latent TB Infection with Short-Course RegimensWorld Tuberculosis (TB) Day 2021World Tuberculosis (TB) Day 2020Linksplus iconState TB Control OfficesAbout Usplus iconMission Statement and Activitiesplus iconDTBE Strategic PlanNational TB Program ObjectivesOrganization ChartAdvisory Groupsplus iconFederal TB Task Force To receive email updates about this page, enter your email address: Email Address			What's this?				Submit


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